NPIMap

Individual provider Active NPI

Chan Woo Lee, MD

  • General Practice Physician
  • Bakersfield, CA
National Provider Identifier
1104909357
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
A89666 Issued in CA
Practice address
1201 24TH St
B-200
Bakersfield, CA 93301-2310
Phone
(661) 324-4431
NPI assigned
Oct 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X A89666 CA Primary

Addresses

Primary practice location

1201 24TH St
B-200
Bakersfield, CA 93301-2310

Mailing address

1201 24TH St
B-200
Bakersfield, CA 93301-2310
Phone (661) 324-4431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Chan Woo Lee Medical, Inc. Current Accepting new patients
Chan Woo Lee Medical Inc. General Practice CurrentSince Apr 1, 2006 Accepting new patients
San Joaquin Wellness & Medical Group, Inc General Practice Past Accepting new patients
Abundant Wellness and Medical Center Inc General Practice PastSince Jan 30, 2016 Accepting new patients

Locations

9240 Garden Grove Blvd
Ste 2
Garden Grove, CA 92844
Phone (714) 610-7575

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1104909357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 24TH ST",
            "address_2": "B-200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012310",
            "telephone_number": "661-324-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 24TH ST",
            "address_2": "B-200",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933012310",
            "telephone_number": "661-324-4431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "CHAN",
        "middle_name": "WOO",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A89666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.